Care changes no cure-all solution

By Wang Pin 王品

The Council of Labor Affairs (CLA) is thinking of implementing a new system next year, for a trial period, in which home help services are to be provided and charged on an hourly basis by a combination of immigrant and local care workers.

The media called this a revolutionary change in how foreign domestic care workers are to be employed in Taiwan: from live-in domestic helper to hourly dispatched workers. The idea behind this new system was inspired by the Danish home help system, in which a single care worker is responsible for visiting several senior citizens within the community.

The proposed system is to have a number of advantages over the current system of immigrant domestic helpers.

It can bring about cost savings for those who do not require around-the-clock care — they will not need to pay a 24-hour wage to the worker, nor will they be responsible for employment security fees or health insurance premiums for immigrant workers.

It also simplifies matters for the host family, who will no longer be responsible for the home help’s bed or board, nor will it be accountable should the immigrant worker abscond.

The new system will also be better for immigrant workers’ human rights, as they should no longer need to worry about being ill-treated by exploitative or abusive employers.

Finally, the new system may well see a reduction in the number of immigrant care workers coming to Taiwan.

Is the point here the hourly-charged services or the fact that the work is to be given to an immigrant? In other words, wouldn’t the advantages of the hourly-charged system be just as applicable to a Taiwanese worker?

We have had a system of pay-by-the-hour home visits by Taiwanese care workers for some time, as part of the home help initiative within the Ten Years Long-term Care Program.

This has attracted large numbers of people looking for a career change and single mothers who have decided to try their hand at community care work.

This is precisely what the Council for Economic Planning and Development had in mind when it was organizing care services in 2002.

Over the past few years, vocational colleges have introduced courses on care provision for the elderly, preparing young people to become care workers and supervisors. Meanwhile, the Department of Health has been legislating to set up long-term care insurance, in which home help is one of the major forms of service provision.

Despite all this, there are still too few families using the government’s home help services. Why?

There are four crucial differences between the home help system and the proposed hourly service system for immigrant care workers.

First, the hourly fee for the proposed program will reportedly be close to NT$240 per hour, more expensive than the NT$180 people currently have to pay for local Taiwanese home care help, unless they are eligible for a government subsidy.

Second, the salary for workers under the proposed program will be more stable. At the moment, Taiwanese care workers within the national home help system get paid NT$150 per hour, which translates into anywhere between NT$25,000 and NT$30,000 per month, although this is subject to fluctuations. By contrast, workers under the proposed program will be paid an agreed and stable salary.

Third, service users can expect more diverse services from the proposed program. Under the current home help system, Taiwanese carers are only expected to work weekdays, visiting either daily or several days a week for one or two hours during the daytime. They do not provide care over many hours in one day, in the evening or at night, for the whole day, at weekends, during holidays, at short notice, or several times on any single day. All of these options, however, are possible under the proposed system for immigrant carers.